Urogenital Flashcards
diagnosing scrotal masses
- can you get above it?
- is it separate from the testis?
- cystic or solid?
what is it if you can’t get above a scrotal mass
inguinoscrotal hernia
hydrocele extending proximally
what is a separate and cystic scrotal mass
epididymal cyst
what is a separate and solid scrotal mass
epididymitis / varicocele
what is a testicular and cystic scrotal mass
hydrocele
what is a testicular and solid scrotal mass
tumour, haematocele, granuloma, orchitis
what is an epididymal cyst and what is it caused by
- benign cyst lesion of the epididymis
- possibly from obstruction of the epididymis
clinical manifestations of epididymal cyst
- small paratesticular swelling
- tender
- thin-walled, translucent cystic lesion
what is the management of epididymal cyst
- remove if symptomatic
what is a hydrocele
- an abnormal accumulation of fluid in the space between the two layers of the tunica vaginalis
causes of hydrocele
primary cause = trauma
secondary cause = reaction to underlying pathology (epididymitis, orchitis, tumour)
clinical manifestations of a hydrocele
- scrotal swelling
management of a hydrocele
- can resolve spontaneously
- aspiration
- surgery = placating the tunica vaginalis/ inverting the sac
what is a varicocele
a persistent abnormal dilation of the pampiniform venous plexus in the spermatic cord
clinical manifestations of a varicocele
- nodularity on the lateral side of the scrotum
- dull ache (worse after prolonged standing)
- male subfertility (increased blood flow raises temp and impairs spermatogenesis)
management of varicocele
surgery to remove
if untreated can lead to infertility
what is an adenomatoid tumour
- most common benign paratesticular neoplasm
- small, solid, grey/white tumours <3cm
where do adenomatoid tumours occur
epididymis, spermatic cord, tunica albuginea
causes of urinary tract obstruction
urinary stones urothelial tumours extrinsic compression prostatic hyperplasia urinary tract malformations strictures
clinical manifestations of acute upper tract obstruction
ureteric colic (pain radiates to groin)
superimposes infection
enlarged kidney
clinical manifestations of chronic upper tract obstruction
flank pain, renal failure, superimposed infection,
clinical manifestations of acute lower tract obstruction
acute urinary retention, severe suprapubic pain, acute confusion
clinical manifestations of chronic lower tract obstruction
urinary frequency, hesitancy, poor stream, terminal dribbling, overflow incontinence
investigations for urinary tract obstruction
- bloods (U&E, FBC, creatinine, PSA)
- urine dipstick and MC&S
- US = hydronephritis (swelling of kidney) or hydroureter
- CT = level of obstruction